Heart disease in men

If you’re over 45 and male, there is no better time for you to schedule a check-up with your doctor to assess the healthiness of your heart.

If you have a history of heart disease in your family, regular check-ups are even more important: men have a higher risk of heart attacks than pre-menopausal women, and men have heart attacks earlier in life.

Surprisingly, the link between cardiovascular disease and testosterone (and other male sex hormones, called androgens) is still controversial. While it’s clear that males get heart disease earlier in life – consistent with earlier development of atherosclerotic plaques – some studies suggest that men with lower levels of testosterone are more likely to die from a heart attack. According to research from the Translational Group at the Heart Research Institute, this may be because androgens enhance the body’s ability to regenerate after injury.

One of the primary bodily responses to the loss of blood flow to an organ, like the heart, is the growth of new blood vessels. Blood vessel growth is kicked into high gear following an injury, as organs need blood to deliver oxygen and to remove waste products from these organs. Work from Daniel Sieveking from the Translational Group has shown that following an injury, new blood vessel growth is much higher in males than females, and that the amount of new blood vessel growth corresponds to the amount of androgens present.

Because testosterone levels in males decrease as they get older, this has potentially important implications for older men.

Age is the largest risk factor for heart disease, and this could be part of the explanation for men. In addition, this study suggests a potential benefit of hormone replacement therapy in older males.